Request for Public Records

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First Name*

Last Name*

Address1

City

State

Zip

Phone Number*

Email Address*

Fax

Is this a commercial request?*

Yes

No

Records*

Please describe the public records you wish to recieve. In order to expediate the search for the records, please be as specific as possible.

Department*

Police

Village Board

Administration

Finance

Building/Zoning

Other

How would you like us to notify you?*

Phone

Email

Fax

Mail

Do you want copy of the records?*

Yes

View Only

Contact First

Email when ready

Signature of person making the request*

The Village will respond to this request within five (5) working days.

Date/Time*

Date/Time

Date/Time

Verify Signature*

By clicking I agree, you agree and acknowledge that 1) your application will not be "Signed" in the sense of a traditional paper document and 2) By signing in this alternate manner, you agree that your electronic signature is valid and binding upon you to the same force and effect as a handwritten signature.